Remote HCC Coding Specialist – Risk Adjustment Expert

Highmark Health; North Dakota; Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking a qualified HCC coder to perform coding for Medicare Advantage, ACA, and ESRD projects, ensuring compliance with CMS guidelines and RPM requirements. You will collaborate with physicians, Quality, Compliance, and leadership to improve documentation and risk capture.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and proficiency with electronic medical record systems. Remote office-based position with travel up to 25%.

Qualifications

• 3 years HCC coding and/or coding and billing.
• Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), and RHIT certifications required.
• Experience with MA, ACA, and ESRD HCC models is preferred.

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD, with retro and prospective models.
• Assists with regulatory audits via first coding review and chart ranking.
• Participates in ad-hoc projects and process-improvement initiatives.
• Engages in RPM coding educational meetings and annual coding Summits.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding, health insurance, healthcare or related field

Tools

Electronic Medical Record systems

Job description

Highmark Health is seeking a qualified HCC coder to perform coding for Medicare Advantage, ACA, and ESRD projects, ensuring compliance with CMS guidelines and RPM requirements. You will collaborate with physicians, Quality, Compliance, and leadership to improve documentation and risk capture.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and proficiency with electronic medical record systems. Remote office-based position with travel up to 25%.